Complications of Endoscopic Retrograde Cholangiopancreatography (ERCP)

Transhepatic cholangiography in patients with suspected biliary disease and nondilated intrahepatic bile ducts

“…Most of the data concerning the success rate and the complications of diagnostic ERCP were published in the mid to late 1970s and early 1980s. The success rate for ERCP varies from 70-91.5% [7,[10][11][12][13]. However, many of these reports do not distinguish between the incidence of bile duct and pancreatic duct opacification and very few directly compare ERC to THC.…”

“…Ginestal-Cruz et al [9] in a small series had similar results. Jander et al [14] compared the results of THC from five different institutions to those of ERC from a large multiinstitutional series [10]. THC in nondilated ducts was successful in about 72% of cases and ERC in 70% of cases.…”

“…ERC has the additional advantages of direct visualization of the ampulla, as well as opacification of the pancreatic duct. Complications from ERCP range from 1-7% [10,[15][16][17][18][19]. Complications include pancreatitis, especially when the pancreatic duct is overdistended with contrast; cholangitis, especially when contrast is injected proximal to an obstruction; and instrumentation injuries.…”

Training and Credentialing in Gastrointestinal Endoscopy

“…In a seminal study, Freeman et al found that high volume centers, defined as those performing ≥1 sphincterotomy per week had fewer overall complications (8.4% vs. 11.1%), fewer severe complications (1.1% vs. 2.9%), fewer hemorrhages (1.1% vs. 2.9%), but similar rates of pancreatitis [69]. Other authors have found higher overall complication rates at lower volume centers [59,70,74] or among less experienced endoscopists [75]. Rabenstein et al found that higher procedure volume (>40 sphincterotomies per year) was a more important predictor of lower adverse events than was overall case volume associated with years of experience [74].…”

ERCP Overview—A 30‐Year Perspective

“…Early efforts were much helped by a multinational workshop at the European Congress in Paris in 1972, organized by the Olympus company. ERCP rapidly became established worldwide as a valuable diagnostic technique, although doubts were expressed in the USA about its feasibility and role [14], and the potential for serious complications soon became clear [15][16][17][18]. ERCP was given a tremendous boost by the development of its therapeutic applications, notably biliary sphincterotomy in the mid-1970s [19-21] and biliary stenting 5 years later [22,23].…”